Gender difference of HIV risks among IDUs in China

描述(申请人提供)：中国面临着艾滋病毒/艾滋病和吸毒流行的双重挑战。注射吸毒者是艾滋病毒/艾滋病流行的驱动力，女性注射吸毒者感染艾滋病毒的风险似乎更高。近年来，有关吸毒和艾滋病毒/艾滋病的性别差异的科学知识有所增加，但在中国看来，尽管女性吸毒和艾滋病毒感染迅速增加，但此类信息仍然缺乏。中国对艾滋病和注射吸毒者的现有研究都是在艾滋病高发地区农村进行的横断面调查，在城市地区的研究很少。为了填补这些信息空白，我们提出了一项纵向研究，以了解HIV感染低发区上海中国静脉吸毒者危险行为和药物使用的性别差异。这项前瞻性流行病学研究将通过定性和定量研究，特别是探讨性别对HIV危险行为变化的影响，以及在24个月的随访期内艾滋病毒、丙型肝炎和乙肝病毒感染的患病率和发病率以及导致HIV发病率的因素。这项研究还将使我们能够确定在24个月的随访期内是否会保持低HIV感染率，并将探索导致上海HIV低流行率的因素。这类研究将对填补中国的研究空白具有非常重要的意义，其研究成果将为有效的艾滋病监测和干预策略提供非常重要的信息。在此基础上，可以规划和实施中国地区有效的艾滋病预防/干预和药物治疗方案，以减少静脉吸毒人群中艾滋病毒的流行，防止艾滋病毒感染从静脉吸毒等高危人群向其他人群传播的可能性。这项建议是NIDA支持的一名外国研究实习生回到上海精神卫生中心的家乡机构后与她在迈阿密大学的导师共同努力的结果，它将进一步扩大上海和迈阿密在艾滋病毒/艾滋病和药物滥用研究方面的合作。

DESCRIPTION (provided by applicant): China is facing a double challenge of both HIV/AIDS and drug abuse epidemics. Injection drug users (IDUS) are the driving force of HIV/AIDS epidemics and female injection drug users appear to be at higher risk for HIV infection. In recent years, scientific knowledge about gender-related differences in drug use and HIV/AIDS has increased, but in China, such information is absent although drug use among women and HIV infection is increasing rapidly. The available studies done in China on HIV/AIDS and IDUs are cross-sectional investigations in high HIV prevalence rural areas; few studies have been done in urban areas. In order to fill these gaps on information, we propose a longitudinal study to understand the gender difference of HIV risk behaviors and drug use among IDUs in Shanghai, China, an area with a low prevalence of HIV infection. This prospective epidemiological research will focus specifically on exploring gender effects on changes of HIV risk behaviors and the prevalence and incidence of HIV, HCV and HBV infections and factors lead to HIV incidence during a 24 month follow-up period by conducting both qualitative and quantitative studies. This study also will allow us to determine whether the low HIV prevalence will be maintained during a 24 month follow-up period and will explore factors that contribute to the low HIV prevalence rate in Shanghai. This kind of research will be very important to fill the research gap in China and the insights from it will provide very important information for effective HIV/AIDS surveillance and intervention strategies. Based on this study, effective HIV/AIDS prevention/intervention and drug treatment programs in China may be planned and implemented to decrease the HIV epidemic among IDUs and prevent the potential for the transmission of HIV infection from high risk groups such as IDUs to other populations. This proposal is the result of collaborative efforts among a NIDA-supported foreign research trainee upon returning to her home institution at Shanghai Mental Health Center and her mentors at University of Miami, and it will lead to further expansion of collaboration on HIV/AIDS and drug abuse research between Shanghai and Miami.